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November 18th, 2009 at 09:02 am

So it begins, the first rationing of health care services

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Within the past 10 years at least a 1/2 dozen friends and family have had their lives saved because of a Mammogram affording early protection.

It is a proven fact that early detection is infinitely increasing the best chances of survival.

So, biting my tongue REALLY HARD to keep this somewhat objective, it is simpler to say, that even Hillary who was a leader in the fight to get PREVENTIVE things like annual Mamograms for women over 40 must be standing with mouth agape.

One has to wonder how TREATING a disease like Breast Cancer can be less expensive than the cost of Annual Screenings.

Now than an “influential” Federal task force makes radical change in breast cancer screening guidelines
including recommendations which challenge use of mammograms,

Here is a link to just one of the many new stories about this next step into health care Rationing.

May I suggest you let your Senators know today and often that this is NOT your idea of “reform” but rather a governmental death sentence to millions of our nations citizens.

Wheat

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  • 1

    Au contraire — I for one am happy to see the medical community raise flags about our hysteria for more and more expensive tests. Yes, preventive testing is a good idea when the rewards justify the cost and trouble. No, preventive testing is not a good investment when it leads to overtreatment and doesn’t save all that many lives. It is just knee-jerk silly to say “all the expensive testing in the world is worth it if it saves just one life” (which I know you didn’t exactly say, but you did go on about “government death sentences”). One of the reasons our national health care system is so screwed up and costly is that we are willing to test anybody for anything – that is, anybody with insurance – but totally neglect the millions with no coverage.

    kathy loomis on November 18th, 2009
  • 2

    Hi Kathy,

    For the record – this is meant almost exclusively in regards to Mammograms and Breast Cancer Screening.

    But since you brought it up – I would disagree that one of the reasons for the problems is testing. It is the need for tort reform. It has been my observation and experience that if our physician’s could worry a bit less about frivilous lawsuits – they would not need to send us for every test under the sun.

    The basis of medical care is supposed to be “do no harm” yet anyone who reads the bill that passed the House will see it does not address the problems, only a few of the symptoms and will almost immediately do great harm to many – at huge expense to all

    Thanks for sharing your thoughts.

    Wheat

    wheat on November 18th, 2009
  • 3

    Sorry, Wheat, you’re wrong. Observation is no substitute for evidence, and the evidence is the other way, as is the notion that the bill will bankrupt us (1/10 the cost per year of the Afghan conflict.)

    Really, go look it up, the numbers are there. Tort reform is a bogeyman, and in the states that have passed it, the results are not equivocal: no net cost savings, but plenty of insurance companies raising premiums. Further, most MD send us for tests because they can, not because they are afraid. They have a built-in aversion to not knowing.

    Since the basis of insurance is the need to have large numbers of people so that we know statistically how to charge for their needs, adding people to the pie while simultaneously adding funds for those people is an insurance companies dream.

    I have read the bill(s, the senate’s version passed today) and while I hate large portions of them, they are in general, as good as we can get.

    The breast cancer issues are dear to my heart (7+ years!) but mammograms are one tool, and not the best necessarily (1/10 false positive is very high). Ditto prostate screening (1/50 false positive). That money is better spent on prevention and research.

    Best

    John

    John on November 18th, 2009
  • 4

    Given history (that of far too many friends and family) I will have to continue to agree to disagree –

    Mammograms and papp smears have resulted in early detection for “me and mine” and created survivors. –

    Nor, is it reasonable to expect any cost savings without serious tort reform. But you are likely correct, the lobby against such reform would be probably impossible to obtain.

    wheat on November 19th, 2009
  • 5

    Yes, no doubt that some have been detected early. Would you wish non-necessary biopsies on the other 1900?
    The issue here is NOT whether or not YOU should choose to have a mamo, or me a prostate screen. It is whether or not it is medically advisable to ADVISE ALL WOMEN to have screenings, regardless of situation, genetics etc. Joy had regular mamos and none showed what would eventually become cancer. If she had had access to MRI’s that would have been better, but if we are doing endless tests that only occasionally useful, we don’t have the $ to do the ones that are.

    Health care is already rationed, by companies that have a vested interest in not showing you how.

    John on November 19th, 2009
  • 6

    Hi Wheat,

    Here is an analysis of the numbers. Note the 1) extra biopsies, and 2) the extra radiation.
    Also note that the recommendation is not NO MAMMO, but instead of every year from 40+, every other year from 50+. NOt exactly a death panel.

    I expected more from you in the realm on analyzing numbers than to take the word of non-mathematicians.

    John

    John on November 19th, 2009
  • 7

    Setting aside the really hot button for me, lack of tort reform…

    Nor, do I believe even when taking pain meds that the money not spent of early detection would find its way to research.

    This particular issue is not about numbers it is about first hand life.

    For too many in my immediate family and among my life long friend, two years would have been a death sentence. For even more, because they did not, it was.

    Sometimes I do consider more than just numbers.

    So while I am sorry to disappoint, I will continue to find a way for annual mammograms for myself and those I love.

    Guess we will just need to agree to disagree – cause this time it is not just about business

    Wheat

    wheat on November 19th, 2009
  • 8

    this is a real quote from the Washington Post article:
    “The new guidelines also recommend against teaching women to do regular self-exams and concluded that there is insufficient evidence to recommend that doctors do the exams or to continue routine mammograms beyond age 74.”

    It_is_ the first rationing of health care. What it is saying (to me) is if you are a woman over the age of 74, it really doesn’t matter if you get breast cancer or not. It’s “not effective” to screen.
    I’m not a huge fan of mammograms, I do know they come back with false positives as well as _false_ negatives.
    (Yes, it happens – that’s why it’s a screening tool). My mother’s cancer was found by the doctor examining her breast after about 5 mammograms that came back okay. But the recommendation is not to have the doctors check the breasts or even do breast self exams.
    Women will blow off their mammograms. (I haven’t even scheduled mine for this year yet.) I know plenty of women, even with family histories of breast cancer, that blow off their mammograms. So this is going to give them more reason not to have it done.
    Two years means more women will die from breast cancer. The cancer will be more invasive and harder to manage.
    And cynic that I am, I wonder why less than a month ago, it was Breast Cancer Awareness month, get your mammograms, do your self exams and now since we’re talking about universal health care, it’s too expensive.

    Robin Andersen on November 20th, 2009
  • 9

    So, your point is that we should do things that increase your chance of harming a large group of women (via excess radiation and unnecessary surgery) because some SMALLER number of people will be helped?

    By that logic, we should all have complete body scans yearly or more frequently, regardless of the fact that more people would die, because a few would be helped.

    Wheat, do you spend money or time doing things you KNOW won’t work? If so, why?

    I have a 20-40% increased risk of cancer over my lifetime, from following those guidelines. Joy has a 100%+ increased risk following treatment. That’s not a small thing. Put away the conspiracy goggles for a time and really examine this. Also, note that you are already rationed by your insurance or lack, but that’s a for-profit thing. How does making health care available to 31 million more people count as increased rationing?

    John on November 29th, 2009
  • 10

    Okay, as always you force me to think

    And, force is very appropriate, because no one “forces” a women to decide to have a mammogram.

    No, my point was/is supposed to be.. this, like so many things, should be between a woman and her doctor and for some issues, her conscience.

    Without self-exam and mammograms – the risk/rewards having been properly explained by my physician(s) in conjunction with my family medical history – following those guidelines could easily have been my death sentence.

    So I guess the answer is I spend time and money doing things that substantially benefit my health – again a decision that should be made in the context of a human, their doctor and their “history”.

    Peace of the Season

    Best to Joy

    Wheat

    wheat on December 6th, 2009
  • 11

    And to you, my friend, and The Henry.

    John

    John on December 7th, 2009
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